Ingredient Deep Dive: Azelaic Acid

Azelaic acid is a naturally occurring active ingredient and a favourite of dermatologists to treat everything from acne to rosacea, pigmentation and more. In fact, we’re calling it out as an unsung skin hero. Our Consultant Dermatologist, Dr Ben Esdaile agrees, “I’m not sure why azelaic acid doesn’t get the attention it deserves. In general, it’s better tolerated than retinoids with an enormous number of skin benefits.”

We asked Dr Ben to break down why it’s such a useful ingredient. 

Skin + Me: Who could benefit from azelaic acid?

Dr Ben Esdaile: Azelaic acid is a naturally occurring substance produced by yeast with a long list of benefits to the skin. It’s extremely versatile and can be used in the treatment of acne, rosacea, pigmentation and improving skin tone. 

It’s useful for acne-prone skin, particularly those with sensitive skin who may struggle to tolerate retinoids. Azelaic acid helps fight acne in a number of ways. It acts as a chemical exfoliator by unblocking the pores that have become blocked in acne. It penetrates down the blocked pore and helps break up the blockage (keratolytic) as well as killing the bacteria that drive acne (Cutibacterium acnes). 

Anti-inflammatory properties make azelaic acid extremely useful in helping reduce the swelling and redness of both acne and rosacea. It also slows the production of melanin (skin pigment) and can help fight the pigmentation caused by acne, sun damage as well as melasma. It’s also safe to use in pregnancy unlike many of the other skin treatments.

“I’m not sure why azelaic acid doesn’t get the attention it deserves. In general it’s better tolerated than retinoids with an enormous number of skin benefits.”

Skin + Me: Why should you use it?

Dr Ben Esdaile: Azelaic acid is particularly useful for those with sensitive and acne-prone skin.  As it’s a mild chemical exfoliator there are also benefits for skin tone and texture. The exfoliation can also help the penetration of other active ingredients into the skin. Its pigmentation-fighting qualities also make it helpful for evening out skin pigment and reducing pigmented acne marks as well as sun-induced spots and melasma.

Skin + Me: What’s the best way to combine it with other ingredients?

Dr Ben Esdaile: Azelaic acid is a chemical exfoliator that actually helps with the penetration of other active ingredients when applied with or in combination with other actives. It can be applied twice daily and is usually best on the entire face directly after a gentle cleanse. 

Azelaic acid can cause some dryness and irritation and so best to slowly increase the frequency of application until the skin is used to it. There are some products that combine azelaic acid with other actives that make it easy to apply in a single application. The other option is to apply azelaic acid in the morning and use other actives at night.”

How to use Azelaic acid and Tretinoin together

With expert guidance, using azelaic acid and a retinoid-like tretinoin together can positively amplify the effects of your treatment.

This is especially true when it comes to treating pigmentation (melasma) and reducing inflammation and excess sebum production associated with acne. 

Azelaic Acid Summary

What is azelaic acid?

Azelaic acid is a naturally occurring substance produced by yeast. Our skin actually produces azelaic acid, but not very much. It’s a type of chemical exfoliant and is particularly effective at fighting acne. It reduces inflammation, bringing down that angry red spot on your chin, and also reduces redness. As it’s a chemical exfoliator, it unblocks blocked pores, while also killing the bacteria that often causes acne. Azelaic acid also slows the production of melanin which can help fight the pigmentation caused by acne and sun damage.

What is azelaic acid used for in skincare?

Azelaic acid is a great all-rounder and a safe, gentle exfoliator that fights acne, redness and pigmentation. 

+ A gentle exfoliator: It gets deep within the pores and removes dead skin cells that can cause dull skin and clogged pores.

+ Reduces inflammation: It soothes irritation and bumps caused by acne or skin reactions.

+ Fights bacteria that cause acne: Azelaic acid is anti-bacterial, and is particularly effective at fighting the bacteria that causes acne.

+ Tackle redness and pigmentation: Not only does it help soothe redness, it also prevents the production of an enzyme that can cause hyperpigmentation and melasma.

Are there any drawbacks to azelaic acid?

Although very occasionally some people can suffer from slight irritation, azelaic acid is a very safe skincare ingredient.

Is there anything else I should know about azelaic acid?

+ It’s pregnancy-safe: Azelaic acid is one of the safe options for treating acne or pigmentation that is considered safe for pregnant women.

+ It may help with rosacea: Azelaic acid is often prescribed to help tackle the pore-clogging and inflammation caused by rosacea. It’s also much less likely to cause irritation compared to other ingredients, which is important as rosacea often leaves skin much more sensitive.

+ It’s safe for celiacs: Despite being made from wheat, azelaic acid isn’t absorbed in high enough quantities to trigger a reaction for celiacs or those with gluten intolerance.

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Medical facts checked by Consultant Dermatologist, Dr Ben Esdaile